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Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder affecting one in 15 people with ovaries worldwide. It’s frequently painful and a cause of infertility.

Dr. Iris Crawford is a Seattle-based naturopathic physician specializing in hormonal issues and cannabis. She took the time to chat about the origins of the disorder, misconceptions surrounding the disease, and the use of cannabis to treat some of its most problematic side effects.

Leafly:Your specialty is in hormonal variations. Do you work with a lot with PCOS patients in your practice?

Dr. Iris Crawford: I did a podcast [about PCOS] a couple of times which generated a lot of phone calls. I had women from around the country calling and going “help me!” because there’s just not a lot of options out there for women with PCOS. There’s a lot of information they aren’t getting from their general physicians.

I quickly learned about the different ways people have been helped by cannabis as medicine when they have so few other options—especially when managing chronic pain.

Dr. Iris Crawford

What’s one thing about PCOS that isn’t well understood?

Crawford: With the majority of PCOS sufferers, there is an issue that if never corrected, never lets you be free of the condition. It lies within insulin resistance. If you have insulin resistance and it continues to be untreated, you will constantly be in the pathology of irregular testosterone production and the entire gamut of symptoms that go with it. Even lean people can have insulin resistance.

Some providers treat weight as a symptom of PCOS, while others treat it as a root cause. Where do things fall in that spectrum? Is it different for everyone?

Crawford: It’s both. It’s very much a “chicken-and-egg” scenario. PCOS can occur while you have extra weight on your body, but insulin resistance also causes weight gain.

The other thing that causes insulin resistance is not weight but stress, especially in women. Stress causes high cortisol which promotes insulin resistance as well.

Crawford: When I grew up, I became very comfortable with recreational use around me because my mom used cannabis. It was never something that was scary for me. I’ve always found it harmless.

When I became a naturopathic doctor, of course, I could see the benefit of plant-based medicine as a whole. I took a class about the use of cannabinoids and how our endocannabinoid system evolved with the plant. I quickly learned about the different ways people have been helped by cannabis as medicine when they have so few other options—especially when managing chronic pain.

Especially pertaining to female reproductive issues like constant inflammation, how do you think cannabinoids can help in managing the chronic pain of PCOS as well as post-rupture treatment?

Crawford: Every type of pain has been successfully treated with cannabis, especially in terms of spasming muscle fibers—organ spasming, as well as general muscle spasms. It helps with the way our brain experiences pain.

It has so many benefits and so few side effects compared to any pain medication, namely something like Vicodin, which is addictive and constipates you. Cannabis is virtually free of side effects.

Not to mention mood as it relates to the side effects of hormonal swings and PMS.

Crawford: I recently began to focus on outreach messages regarding women and depression. Women are two to four times more likely to attempt suicide.

Anxiety, depression, and insomnia are all issues related to hormone imbalances. Hormonal imbalances are twice as likely to happen in women, and this isn’t with women who are perimenopausal — I’ve treated a girl as young as 16 who was having panic attacks due to hormone imbalance. These hormonal imbalances are caused by stress which is part of a syndrome called Adrenal Fatigue. This has become an epidemic among women and I am dedicating the rest of my career to it.

Crawford: And it comes back to the cortisol connection to blood sugar. Every woman who struggles with PCOS should be evaluated for adrenal fatigue as well as hormonal imbalance. It’s part of the whole picture. Facial hair and acne can also be typical complaints of sufferers with PCOS.

Most of the work I do with women will involve a weight loss component. I have an approach that helps take the extra weight off very quickly and then allows them to keep it off without dieting. It works as a reset to metabolism. It’s a huge piece of the puzzle for sufferers, as they have usually tried every diet out there.

Crawford: Yep. I work with women who can’t lose weight even on a keto diet, so it’s very frustrating. That’s where I become a detective. There is an underlying cause as to why your body won’t release that fat. Usually, it’s a hormone imbalance and/or a broken metabolism from a history of dieting, and also environmental toxins.

Oftentimes my experience with Western medicine has been reduced to a number on the scale. The vast majority of my doctors have focused on that number, which can bring a lot of guilt and shame into picture. The general conclusion is you’re sick because you’re fat.

Crawford: Yes, totally. You’ll often see the focus on BMI, which has no relevance to your general health. The Incredible Hulk would be obese according to BMI standards. Percentage of body fat is really where it’s at.

If someone wasn’t based in the Pacific Northwest, how could they access your service?

Crawford: I have patients calling from all over the country and I’m able to help them long distance. I don’t refer out because it’s so specialized. It’s called the Crawford Hormone Revitalization Method and it’s my specific specialty. It grew out of me seeing, on a nationwide level, women who were not getting the help they needed.

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